Abusive alcohol consumption among adolescents: a predictive model for maximizing early detection and responses.

OBJECTIVE: To present a predictive model of alcohol abuse among adolescents based on prevalence projections in various population subgroups. STUDY DESIGN: Cross-sectional study. METHODS: The sample consisted of 785 adolescents enrolled in the second year of high school in Rio de Janeiro, Brazil. Alcohol consumption was assessed using the Alcohol Use Disorder Identification Test. Socio-economic, demographic, family, individuals, and school-related variables were examined as potential predictors. The logit model was used to estimate the prevalence projections. Model fitting was examined in relation to the observed data set, and in a subset, that was generated from 200 subsamples of individuals via a bootstrap process using general fit estimators, discrimination, and calibration measures. RESULTS: About 25.5% of the adolescents were classified as positive for alcohol abuse. Being male, being 17-19 years old, not living with mothers, presenting symptoms suggestive of binge eating, having used a strategy of weight reduction in the last 3 months, and, especially, being a victim of family violence were important predictors of abusive consumption of alcohol. While the model's prevalence projection in the absence of these features was 8%, it reaches 68% in the presence of all predictors. CONCLUSIONS: Knowledge of predictive characteristics of alcohol abuse is essential for screening, early detection of positive cases, and establishing interventions to reduce consumption among adolescents.

Status of cis and trans fatty acids in Brazilian adolescent mothers and their newborns.

STUDY OBJECTIVE: The objective was to quantify cis and trans fatty acids in maternal plasma and infant cord plasma from adolescent mothers. DESIGN: From 80 adolescent healthy mothers, we sampled postpartum maternal blood and umbilical cord blood at birth. Trans fatty acids (tFAs), linoleic (18:2), and arachidonic (AA, 20:4) acids of the n-6 family, and α-linolenic (18:3), eicosapentaenoic (20:5) and docosahexaenoic (22:6) acids of the n-3 family were analyzed by gas-liquid chromatography. Results were expressed as a percentage of total fatty acids. RESULTS: Linoleic fatty acid was present in greater proportions in the maternal plasma than in that of the umbilical cord, whereas AA was present in greater proportions in the total lipids of umbilical cord blood. Docosahexaenoic acid was the long-chain polyunsaturated fatty acid of the n-3 family that was predominant in both maternal and umbilical cord plasma. The tFAs in the maternal plasma had a negative correlation with oleic acid and linoleic acid. Linolenic acid had a positive correlation with cephalic perimeter upon birth. A tendency for a negative correlation between trans isomers and gestational age at birth (P = .05) was observed. CONCLUSIONS: Long-chain polyunsaturated fatty acids, which are important to fetal growth and development, were found in greater quantities in the cord blood of newborns of adolescents than in the maternal blood, indicating a priority of transfer of AA and docosahexaenoic fatty acids to the fetus. Despite the lower levels of tFAs found in maternal blood, we verified potential risk for premature birth.

Risk behaviors for eating disorders in Brazilian dancers.

This study investigated the frequency of risk behaviors for eating disorders and their association with anthropometric, demographic, and socioeconomic variables in Brazilian professional dancers. Portuguese-language versions of the Eating Attitudes Test and of the Bulimic Investigatory Test, Edinburgh (BITE) were applied to 39 female and 22 male dancers considered to be some of the best classical ballet performers in Brazil. Prevalence ratios (PR) and 95% confidence intervals (CI) were estimated. Risk behaviors for eating disorders were observed in 31% of the dancers. Those who had a percentage of body fat above (PR=4.04; 95% CI=1.42-11.47) or below (PR=3.57; 95% CI=1.04-12.24) what is considered normal for the profession, and those who lived alone (PR=3.13; 95% CI=1.16-8.48) presented higher risk for eating disorders. In conclusion, the frequency of risk behaviors for eating disorders among the Brazilian dancers was high, which seems to be associated with the physical requirements of the profession. Those who are outside the BF% expected for dancers and those who live alone are the groups most vulnerable to developing eating disorders, and thus are the ones which are most in need of receiving special attention in regard to the intervention measures.

A comparison of distribution curves of body mass index from Brazil and the United States for assessing overweight and obesity in Brazilian adolescents.

OBJECTIVE: To assess the validity of recommendations for use of the 85th and 95th percentiles of body mass index (BMI) of the population in the United States of America as a screening tool to assess overweight/obesity in adolescents. METHODS: We investigated the relation between BMI and percent body fat in 1,540 adolescents (717 males and 823 females) aged 10 to 17.9 years old from a private high school in Niterói, a city in the state of Rio de Janeiro, Brazil. We used bioelectric impedance, with the appropriate equations for adolescents, to estimate percent body fat, which served as the gold standard (30% for girls and 25% for boys) to calculate the sensitivity and specificity of the 85th and 95th percentiles of the United States and Brazilian distribution curves of BMI. RESULTS: Sensitivity and specificity were high (above 80%) for the Niterói boys, except for the 85th percentile of the Brazilian curve (specificity = 61.8%) and for the 95th percentile of the United States curve (sensitivity = 55.4%). For the Niterói girls, the 85th- and 95th-percentile BMI cutoff points, from both the United States and Brazilian curves, showed low sensitivity, and that sensitivity decreased with age. Specificity was high for the girls, and much higher than it was for the boys. CONCLUSIONS: These data suggest that using BMI to screen for overweight/obesity in adolescents can generate a high percentage of false-positives for Niterói boys and an even higher percentage of false-negatives for Niterói girls. A more universal approach to using anthropometric measures to screen for overweight/obesity should be developed, preferably linked to stages of maturation.

[Socioeconomic and demographic indicators and nutritional status of children in a rural land settlement in Rio de Janeiro]. / Indicadores sócio-econômicos, demográficos e estado nutricional de crianças e adolescentes residentes em um assentamento rural do Rio de Janeiro.

This study evaluated socioeconomic indicators and nutritional status in 201 children and adolescents in a rural land settlement in São José da Boa Morte, Rio de Janeiro. Nutritional deficit was defined as a value below -2 z score for the reference median from the National Center for Health Statistics (NCHS) for weight-for-age (W/A) and stature-for-age (S/A) for children under five years of age and weight-for-stature (W/S) and S/A for children from 5.0 to 9.9 years. For adolescents, the study used cut-off points at the 5th percentile (thin) and 85th percentile (overweight) from the distribution of body mass index (BMI) in the Brazilian population. According to the study, 53.8% of the households had 4 to 6 members, 34.5% had rudimentary cesspools, 31.2% had no running water, 11.0% had no bathroom, 58.2% burned or buried their garbage, and 13.6% of the mothers were illiterate. No case of nutritional deficit was found in the 0-4.9 year age bracket, and in the 5-9.9 year bracket there were one underweight and three overweight children. The authors concluded that the low prevalence of nutritional deficits in the study group, despite the exposure to risk factors, may be related to the presence of protective factors like access to health services, and that there was an important rate of overweight among adolescents (13.3%).

[Distribution of body mass indices of a Brazilian population under 25 years of age]. / Distribuição dos valores do índice de massa corporal da população brasileira até 25 anos.

This paper presents the percentage distribution of the body mass index of the Brazilian population from birth to age 25, based on a national survey conducted in 1989. Survey data show that body mass index decreases from birth until around 6 years of age, reaching a plateau at 8 years and progressively increasing until the age of 19 or 20 years for females and 20 or 21 for males. The survey also revealed that after the age of 12 females present a greater body mass index than males, as well as a larger range of percentile values (from 3 to 97). A comparison with data from other countries showed that the body mass index profile in Brazil is similar to that observed in France, Great Britain, and the United States. Before the age of 6, Brazilian youngsters have a mean body mass index that resembles that of North American children, and a lower one thereafter. A comparison between the median body mass index of Brazilian and British youngsters revealed consistently lower values among Brazilian females. When compared to that of France, Brazil's male population has a systematically lower body mass index after the age of 8. It is suggested that the data presented in our study be used only for comparing groups of individuals and studies, and not for screening or clinical monitoring, due to the great variability in growth patterns during adolescence.

[Factors associated with obesity among adolescents]. / Fatores associados à obesidade em adolescentes.

INTRODUCTION: Obesity during adolescence is considered a strong predictor of adult obesity. The present study assessed the overweight/obesity prevalence and associated factors in middle class adolescents of a school in the city of Niteroi, Rio de Janeiro, Brazil, and evaluated the correlation between body mass index with anthropometric measures of fatness. METHOD: The analysis covered 391 students aged from 15 to 17 years. Adolescents had their weight, height, skinfold thickness and upper arm circumference measured at school. A food frequency questionnaire (list of 79 items) and a questionnaire including food habits, parents anthropometric characteristics, physical activity and other factors associated with obesity were filled out by the adolescents at school. RESULTS: The proportion of overweight individuals among boys (Body Mass Index (BMI) greater than the 90th percentile of the Brazilian population) was 23.9%, whereas the prevalence among girls was 7.2%. The fact of being on a slimming diet was a relevant factor for the prediction of BMI and was 7 times more frequent among girls than among boys. Among boys, being on a diet, absence of breakfast, and family body appearance were positively associated with BMI. Among girls these variables were also significantly associated, whereas age at menarche was negatively associated with BMI. Hours of watching TV/video/video-game was associated with BMI only among boys. The correlation coefficient between BMI and measures of fatness varied from 0.7 to 0.9 for boys, and from 0.8 to 0.90 for girls. CONCLUSIONS: BMI appears to be a good indicator of obesity among adolescents and showed that girls demonstrated an exaggerated preoccupation with body image and stereotyped slim body patterns.

[Evaluation of body composition by means of anthropometric measures in obese and non obese adolescents from two socioeconomic levels]. / Avaliação da composição corporal através de medidas antropométricas, de adolescentes obesas e eutróficas de dois níveis sócio-econômicos.

Anthropometric measures of 120 female adolescents were analyzed, 60 of them from a low socio-economic level (LSEL),and 60 from a high socio-economic level (HSEL), with 30 obese and 30 non-obese in each group, in an attempt to verify differences between the socio-economic levels in relation to the body-composition and the distribution of fat throughout the body. The weight,height, upper arm circumference and 4 skin folds (triceps, biceps,subscapular and suprailiac) were measured, and the arm muscle area, arm fat area and percentage of body fat were estimated. Those who were obese from LSEL presented an average height lower (p<0.05) than the obese from HSEL, and a greater proportion of this group presented a height deficit for their age. The arm muscle area was greater (p<0.05) in the obese from HSEL, but the percentage of body fat was similar in the two groups as well as the measures of the isolated skin folds. The increase in fat in the obese from LSEL, when compared with the non-obese, was 2.8 times greater than the muscle. In the HSEL, this increase was 1.3 times greater. It was concluded that the obese from both socio-economic levels presented different types of obesity in relation to body composition,but were similar in relation to body fat distribution.

Adaptacao do criterio antropometrico para avaliacao do estado nutricional de adolescentes em dois niveis socio-economicos no municipio de Sao Paulo / Adaptation of the criterion anthropometric for evaluation of the nutritional status of adolescents in two socioeconomics levels in the municipality of Sao Paulo

Foi realizada a avaliacao nutricional em 294 adolescentesdo sexo feminino de 11 a 18 anos, sendo 192 estudantes de um colegio de nivel socio-economico alto e 102 residentes em 5 favelas do Municipio de Sao Paulo. A avaliacao foi realizada com base na adequacao em relacao ao percentil 50 das distribuicoes de E/I e P/I. Foi feita uma adaptacao destas duas distribuicoes para avaliacao da relacao P/E. O metodo consistiu em verificar a partir da estatura real, independente da idade cronologica, o peso adequado a esta estatura. Observou-se uma prevalencia maior de baixa estatura nas adolescentes de nivel socio-economico baixo (36,3% vs. 13%). Os dois criterios de avaliacao, P/I e P/E, nao resultaram em grandes diferencas de diagnostico nos adolescentes de alto nivel socio-economico. Nas adolescentes de baixo nivel socio-economico, observou-se um aumento importante na prevalencia de obesidade (4% vs. 23%), e uma reducao na prevalencia de desnutricao atual (48% vs. 18%) quando P/E foi utilizado. A prevalencia de obesidade com baixa estatura foi maior nas adolescentes de baixo nivel. Os resultados sugerem que em paises subdesenvolvidos, onde a desnutricao compromete ocrescimento dos individuos, a avaliacao nutricional pelo P/I pode induzir a um erro de diagnostico com subestimacao da obesidade .

Indicadores das condiçöes nutricionais na regiäo do Polonoroeste: VII. Estudo da prevalência de desnutriçäo e diarréias, 1985 / Indicators of nutritional status in the Polonoroeste area: VII. Prevalence of malnutrition and diarrheas, 1985

Os autores realizaram um estudo do estado nutricional por antropometria num grupo de 405 crianças de 3 a 72 meses de idade, residentes na área urbana da cidade de Cáceres - Regiäo do Polonoroeste no Estado do Mato Grosso. Mediante a aplicaçäo de um questionário ao responsável pela criança, pesquisou-se a ocorrência de diarréias na mesma populaçäo. O objetivo do estudo foi verificar a prevalência de desnutriçäo e a freqüência de diarréias nessas crianças. Utilizaram-se as classificaçöes propostas por GOMEZ e WATERLOW para verificar a prevalência e a natureza da desnutriçäo. Foi verificado que a desnutriçäo ocorreu em 33% das crianças segundo a classificaçäo de GOMEZ. Segundo os critérios de WATERLOW a forma de desnutriçäo de maior proporçäo encontrada foi a pregressa, com percentual de 36%. Entre as crianças desnutridas a freqüência de diarréias foi de 47% sendo a relaçäo entre diarréia e desnutriçäo estatisticamente significante